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Transitioning from NICU/tube feedings to bottle to breast

My LO was born at 31 weeks due to Pre-E. She spent exactly one month in the NICU and came home with us 2 1/2 weeks ago. She was 3.1 at birth and was 4.7 the day she left the hospital. As of last Friday, she was up to 5.8! She's doing great!

My questions pertain to bf'ing. When she was first born, I pumped while in the hospital (was in for 14 days total due to Pre-E, 8 of those days after her birth) she was given her food via tube feeds at first and then was introduced to a bottle (all of mama's milk) and then eventually graduated to all 8 feedings by bottle (as required for her to be released from the hospital). At time of discharge she was eating 35mls/feeding. (5 feedings of pumped milk and 2 bottles a day of Neosure as a supplement).

Once we got her home, at the suggestion of the LC, we put her to breast 1-2 times/day with the aid of a nipple shield (her mouth is tiny and they thought she might not be able to latch properly because of it) and she took to it right away!

Here's my issue- when I was pumping and she was eating her meals by bottle, I knew EXACTLY how much she was getting. I guess I'm trained in that way and it's hard for me to bf her and NOT know how much she is getting. Also, when she was on bottles, I fed her every 3 hours. With bf'ing she wants to eat more often.

So, how do I tranisition from pumping to just bf'ing her, not knowing how much she is getting and not keeping my eye on the clock? Her Ped said that I could also do one (not longer than 5 hour) stretch at night so I'm not waking her every 3 hours.

Re: Transitioning from NICU/tube feedings to bottle to breast

Hi mama! Congrats on your LO!

The NICU stays are good at zapping our self confidence aren't they?So you are only doing two feedings at the breast now? In reality she should at least be trying at the breast every feeding, even if she doesn't transfer much milk. Then you can always bottle feed pumped milk afterward.

Now that she is partially on the breast, I would feed as much and as long as she wants. And try and trust in your body that she is getting enough from you. Make sure to monitor diapers, wet and poopy, and as long as she is having adequate diapers you know she is getting enough.

Remember, you are not managing an inconvenience; You are raising a human being ~ Kittie Frantz
Unthinking respect for authority is the greatest enemy of truth ~ Albert Einstein
First they ignore you, then they ridicule you, then they fight you, then you win ~ Mahatma GandhiLooking for more information about vaccines?

Remember, you are not managing an inconvenience; You are raising a human being ~ Kittie Frantz
Unthinking respect for authority is the greatest enemy of truth ~ Albert Einstein
First they ignore you, then they ridicule you, then they fight you, then you win ~ Mahatma GandhiLooking for more information about vaccines?

Re: Transitioning from NICU/tube feedings to bottle to breast

Congrats on your daughter. My DD was born at 30 weeks, and spent 7 weeks in NICU. We were fortunate in that the hospital where she was born, they'd fully support you if you wanted to breastfeed, and wouldn't release the baby until they were fully suckle feeding, be that breast or bottle, or combination of both.

We were doing both when we came home. She was having a feeding at the breast attempt at each feed, and then I'd top up with EBM.

But after a week, we gave up on the top ups in the day time. It was a huge leap of faith, as the NICU structured feeding environment is totally artifical in a breastfed baby, and is only designed around formula fed babies and staff ease so that they're not constantly having to feed babies.

We went from a 4 hourly NICU feeding timetable, to roughly 2-3 hourly in the day, on demand feeding, basically when she woke from her naps.

At night time we continued giving a full feed by bottle of EBM, so we could control how much she had, and therefore (thankfully) how long she'd sleep. We knew that 70ml would last her about 4 hours, and it did. So when DH was giving her that bottle of EBM, I'd express. It was also quicker that way, because she would tire easily with BF, and at night we wanted to maximise our sleep.

We stopped the night time bottles of EBM after about a month or so, and went totally BF.

It's hard to mentally get yourself around the change, but definitely what you need to do to get the breastfeeding established properly, and successfully.

Re: Transitioning from NICU/tube feedings to bottle to breast

I'm a NICU nurse.. and what you're saying I hear all the time from moms. I had a hard time doing things "normal" when I had my son. I know I'm not a mom of a NICU grad, but it is SOO hard to let go of the NICU rules and fly solo isn't it?
You have received some fantastic advice. I completely agree with the previous posters.. watch your diaper outputs, top off with a bottle of pumped milk if you feel you need to...

Congratulations on you baby, graduating to home from the NICU, and I am really proud of you pumping milk for your baby for all this time. I had no clue how much work went into providing milk until I got to do it myself. I admire your hard work!! you are doing a great job!!!